Canada lacks oversight on online medical information, study finds
Canada may have a state-run health-care system, but the federal government is noticeably reticent when it comes to providing medical information online.
Wikipedia entries or pharmaceutical company websites are almost always the top hits when Canadians Google the name of a brand or generic drug, while in the United States, Web surfers are directed to a profile of the drug from the government-run National Library of Medicine’s website.
At a time when Internet searches are common for any type of medical problem – and when the medical credentials of Dr. Wikipedia are dubious at best – the lack of federal government oversight on drug searches raises concerns about the accuracy of information Canadians are receiving.
“There’s estimates that thousands of Canadians suffer adverse drug reactions every year, and providing people with accurate information is fundamentally important,” said Michael Law, an assistant professor at the Centre for Health Services and Policy Research at the University of British Columbia. “People are clearly using the Internet, so we should be interested in what type of information they’re finding.”
Prof. Law and his colleagues conducted searches of nearly 300 drugs, and their results, published online this week in the Annals of Pharmacotherapy, showed that Wikipedia turns up as the first search result about 85 per cent of the time when looking up the generic name of a drug. Industry websites crop up nearly 80 per cent of the time when searching the brand name.
Compare this to the U.S., where about three-quarters of the time Google searches yielded a drug synopsis from the NLM, which is a branch of the National Institutes of Health, the country’s medical research agency.
The main reason for this discrepancy is that the U.S. government struck a partnership with Google last year to display its results more prominently when residents are searching prescription drugs online.
In Canada, no such deal exists – and researchers are encouraging federal regulators to step forward.
Tim Vail, spokesman for Federal Health Minister Leona Aglukkaq, said the government is hoping to address the issue within the next year as it looks to strengthen its online presence. He said Ottawa is looking at all options, including working with search engines like Google to make sure accurate information from Health Canada is more prominent for Canadians doing Web searches on prescription drugs, the next pandemic or any other health issue.
“We’re continuing to modify our website and look at ways that will improve searches for Canadians so that we will be more prominent in search engines when Canadians are looking for it,” Mr. Vail said. “We do realize that we are a trusted name and a trusted brand among Canadians.”
Prof. Law described the online world for medical information as the “Wild West” in terms of what Canadians can find. He said Wikipedia often omits certain information on drugs, and pharmaceutical companies could potentially leave out adverse side effects.
One pharmaceutical company defended its online presence. Pfizer, which makes the cholesterol drug Lipitor, said it provides up-to-date scientific information on its website. A company spokeswoman, however, did encourage Web surfers to check the source of their information and to always seek an opinion from health professionals – a message echoed by Prof. Law.
“I would hope that our study would also make patients aware of the fact that the information they read online may be inaccurate or incomplete,” Prof. Law said. “Patients should be sure to talk to their health-care professionals about information they might find online.”
Slash your drug costs
Lorene Coates used to pay $200 to $250 for her prescriptions before pharmacies created discount drug plans.
A retiree, Coates became eligible for the Medicare drug card in March and now only spends about $51 each month for her hypertension medicine.
She pays a total of $25 a month for two brand name medications and $26 for a prescription drug card. She also mail orders generic prescriptions and gets them for free under the Medicare plan.
“That’s a great savings for me,” said the former Hattiesburg American employee who retired three years ago. “I was having to pay the full price and (then) I did get all the generics I could.”
Generic is the word to remember when it comes to saving on prescription drugs. Pharmacies across the country are now touting generic prescription plans as money savers with chains like Wal-Mart, Target and Fred’s offering a month’s worth of generic prescription drugs for $4 to $5.
Locally owned and operated Owl Drug Store, a service of Hattiesburg Clinic, offers $5 monthly prescriptions on more than 100 generic drugs, ranging from allergy to diabetic to mental health medications. Many prescriptions also are available in a 60-day supply for $8 and a 90-day supply for $12.
Nancy Rohr, pharmaceutical technician at Southwest Drug Co. on Adeline Street, said the store works with customers to give the lowest price on drugs. She said generic drugs are often the best option. Although they don’t offer a discount plan, Rohr said choosing generic drugs is the key to getting the best bargain.
“If they have a drug plan, we see if it goes through. If it doesn’t, we see if we can find a drug that’s comparable to the one the doctor wrote and is generic,” she said. “If there isn’t we call the doctor to see if there’s something else they can take.”
The Food and Drug Administration’s Web site suggests customers ask their doctor or pharmacist if a less expensive drug will work. The Web site also recommends comparing prices among other pharmacies and using assistance programs.
Sandra Dykes, 67, of Petal gets the bulk of her prescriptions filled through her husband’s military TRICARE insurance plan. When she can, she buys generic drugs for three of her eight prescriptions at Wal-Mart.
Generic drugs have the same active ingredients and effects as brand-name drugs, but they can cost 30 percent to 80 percent less, the FDA’s Web site says.
Older adults with Medicare are eligible for coverage under Medicare Part D drug prescription plan. Rohr said many customers are on this plan and know what medications are covered. She suggests diabetics shop at medical supply stores for test strips and syringes since the purchase will be covered by insurance.
If you can’t afford to buy certain medications, some companies offer free or discounted drugs for people who aren’t eligible for Medicare or insurance.
Launched in 2005, the Partnership for Prescription Assistance is an industry initiative to help patients find assistance programs faster. It provides a single point of access to more than 275 public and private PAPs – including more than 150 programs offered by drug companies. The PPA also will show people how to contact Medicare and other government programs.
Rohr said the pharmacy works with doctors to make sure customers get the medicine they need at an affordable price.
“We try the best we can to give the most reasonable price and service and we also try to thoroughly explain what medicines are for,” she said.
Don’t underestimate the danger of drugs from abroad
Ryan Thomas Haight, a baseball card collector, fantasy sports aficionado, straight-A student and varsity tennis player from La Mesa, died 10 years ago. The facts are simple and tragic: Sometime on Feb. 12, 2001, Haight took a cocktail of painkillers that he had purchased over the Internet without a prescription, had a serious reaction to it and died. Ryan, obviously, wasn’t a hardened criminal, he was simply experimenting with controlled substances – as many teenagers do – and found that widespread, loosely regulated Internet pharmacies made it very easy to get nearly any type of commonly abused prescription drugs. Haight got his drugs after filling out a questionnaire that was “examined” by a doctor who had never met him.
While nothing can make up for the loss of Ryan, some good did come of his death. Seven years after he died, partly at his own mother’s urging, Congress approved a law that bears his name: the Ryan Haight Online Consumer Protection Act. It prohibits sales of controlled substances over the Internet without a valid prescription issued during an in-person doctor’s visit. It’s a good start, but if Congress wants to get serious about preventing other tragedies, it must do more.
Although the Haight Act has cut the number of fly-by-night pharmacies based in the United States, in fact, most illegitimate pharmacies exist in other countries. It’s not practical for the United States to actually regulate these entities beyond its borders, but it is in our best interest to coordinate with other countries in efforts to address the growing threat of fake drugs and illegitimate pharmacies.
As we know, a (supply) chain is only as strong as its weakest link. In an economy that is growing more global by the day, the only way to ensure absolute safety of all domestic drugs would be for the American government to somehow enforce American pharmaceutical regulations in other countries – and that’s clearly impossible. What is possible is for stronger and better international cooperation in order to share information on possible counterfeiters, enact effective standards and reviews, and limit the opportunity for counterfeit drugs to get into the pipeline.
Governments and medical professionals alike simply need to do a better job of educating the public about the dangers of unregulated online pharmacies. While drugs sold at physical pharmacy counters in the United Kingdom, Canada and other developed countries can be presumed safe, most online pharmacies that claim to operate in these countries maintain little more than mail drops there and instead import drugs from China, India and other countries that have little quality control over medicines. Some online medicines from “Canada” are sugar pills; others are deadly. Quite simply, Americans need to realize that a web page that shows a maple leaf – or even a mailing address in a familiar sounding, English-speaking city – is not a sign of safe, sound medications.
The United States has the safest drug supply and the best pharmacy system in the world. We must ensure that the legacy of Ryan Haight is not wasted: Ten years after his death, lawmakers should act to ensure that illegal online drug pushers are put out of business. No one should ever have to bet his or her life on the legitimacy of an online pharmacy.